Atopic dermatitis, also known as eczema, is a non-contagious inflammatory skin condition. It is a chronic disease characterized by dry, itchy skin that can weep clear fluid when scratched. People with eczema also may be particularly susceptible to bacterial, viral, and fungal skin infections.

Eczema (Atopic Dermatitis) Causes & Strategies for Prevention

A combination of genetic and environmental factors appears to be involved in the development of eczema. The condition often is associated with other allergic diseases such as asthma, hay fever, and food allergy. Children whose parents have asthma and allergies are more likely to develop atopic dermatitis than children of parents without allergic diseases.

Approximately 30 percent of children with atopic dermatitis have food allergies, and many develop asthma or respiratory allergies. People who live in cities or drier climates also appear more likely to develop the disease.

The condition tends to worsen when a person is exposed to certain triggers, such as

  • Pollen, mold, dust mites, animals, and certain foods (for allergic individuals)
  • Cold and dry air
  • Colds or the flu
  • Skin contact with irritating chemicals
  • Skin contact with rough materials such as wool
  • Emotional factors such as stress
  • Fragrances or dyes added to skin lotions or soaps.

Taking too many baths or showers and not moisturizing the skin properly afterward may also make eczema worse.

Eczema (Atopic Dermatitis) Treatment

Skin Care at Home

You and your doctor should discuss the best treatment plan and medications for your atopic dermatitis. But taking care of your skin at home may reduce the need for prescription medications. Some recommendations include

  • Avoid scratching the rash or skin.
  • Relieve the itch by using a moisturizer or topical steroids. Take antihistamines to reduce severe itching.
  • Keep your fingernails cut short. Consider light gloves if nighttime scratching is a problem.
  • Lubricate or moisturize the skin two to three times a day using ointments such as petroleum jelly. Moisturizers should be free of alcohol, scents, dyes, fragrances, and other skin-irritating chemicals. A humidifier in the home also can help.
  • Avoid anything that worsens symptoms, including
    • Irritants such as wool and lanolin (an oily substance derived from sheep wool used in some moisturizers and cosmetics)
    • Strong soaps or detergents
    • Sudden changes in body temperature and stress, which may cause sweating
  • When washing or bathing
    • Keep water contact as brief as possible and use gentle body washes and cleansers instead of regular soaps. Lukewarm baths are better than long, hot baths.
    • Do not scrub or dry the skin too hard or for too long.
    • After bathing, apply lubricating ointments to damp skin. This will help trap moisture in the skin.

Wet Wrap Therapy

Wet wrap therapy includes three lukewarm baths a day, each followed by an application of topical medicines and moisturizer that is sealed in by a wrap of wet gauze.

Treatment may include wet wrap therapy to bring the condition under control. Patients and their caregivers also receive training on home-based skin care to properly manage flare-ups once they leave the hospital.

Eczema (Atopic Dermatitis) Complications

The skin of people with atopic dermatitis lacks infection-fighting proteins, making them susceptible to skin infections caused by bacteria and viruses. Fungal infections also are common in people with atopic dermatitis.

Bacterial Infections

A major health risk associated with atopic dermatitis is skin colonization or infection by bacteria such as Staphylococcus aureus. Sixty to 90 percent of people with atopic dermatitis are likely to have staph bacteria on their skin. Many eventually develop infection, which worsens the atopic dermatitis.

Viral Infections

People with atopic dermatitis are highly vulnerable to certain viral infections of the skin. For example, if infected with herpes simplex virus, they can develop a severe skin condition called atopic dermatitis with eczema herpeticum.

Those with atopic dermatitis should not receive the currently licensed smallpox vaccine, even if their disease is in remission, because they are at risk of developing a severe infection called eczema vaccinatum. This infection is caused when the live vaccinia virus in the smallpox vaccine reproduces and spreads throughout the body.

Furthermore, those in close contact with people who have atopic dermatitis or a history of the disease should not receive the smallpox vaccine because of the risk of transmitting the live vaccine virus to the person with atopic dermatitis.

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